Comparison of single dose meperidine, butorphanol, and dihydroergotamine in the treatment of vascular headache

Abstract

We treated 64 emergency room patients with a primary vascular headache with dihydroergotamine (DHE), meperidine, or butorphanol. Post-treatment pain scores were lowest in the DHE group (p less than 0.01). Eight of 21 patients receiving DHE had greater than 90% reduction in pain compared with three of 19 patients receiving butorphanol and none of 22 receiving meperidine.

Parenteral Dihydroergotamine for Acute Migraine Headache: A Systematic Review of the Literature

“…Two independent reviewers identified 53 abstracts as potentially relevant to this review. Independent review of the full manuscripts of the 53 potentially relevant studies resulted in 11 studies being included in this review [12][13][14][15][16][17][18][19][20][21][22] (Figure 1). There were no disagreements between 2 independent reviewers about inclusion of studies in the review.…”

“…[15][16][17][18][19][20][21][22] Because of significant heterogeneity in study methodology (Table), particularly with regard to the comparison treatments, studies were not pooled statistically. The results, however, are summarized below and presented in Figures 2 to 9.…”

“…15 Results from 3 trials showed that dihydroergotamine with an antiemetic was equally or more effective in reducing headache pain than other treatments ( Figure 3) 18,19,21 and as effective as other treatments in 3 studies that reported reduction in headache pain on a visual analog scale (Figure 4). [15][16][17] Three studies indicated that dihydroergotamine with an antiemetic was equally or more effective in improving functional ability ( Figure 5), 17,19,20 whereas the 1 study that reported the number of patients needing ''rescue'' medication did not find a significant difference between groups ( Figure 6). 17 Dihydroergotamine with an antiemetic was as effective as other treatments with regard to reduction in nausea in 2 studies (Figure 7), 17,18 and patients treated with dihydroergotamine with an antiemetic were as likely or less likely to have a migraine relapse in 4 studies (Figure 8).…”

Ergotamine and dihydroergotamine: A review

“…Clinically, DHE has been proven to be highly effective in treating acute migraine with or without aura [37][38][39] and may be administered at any time during the attack, including the aura, in contrast to the triptans. Repetitive IV DHE is a treatment of choice for status migrainous [28] and is particularly effective for the treatment of chronic daily headache (transformed or chronic migraine) and analgesic rebound headache.…”

Management of primary headache in emergency services of Santos and surrounding towns

“…Dihydroergotamine (DHE) has had a role in the treatment of migraine for many years and most protocols of treatment recommend the inclusion of DHE for patients who are not chronic abusers of ergotamine (3,4,(14)(15)(16) . Alternatives to oral tablets should be used in preference, considering that nausea is a common side effect.…”